Lyme Disease Science Blog

Canada may see new tick-borne threat: Babesia

Last year, Canadian public health officials and legislators made great strides in recognizing the existence and threat within their country of Borrelia burgdorferi (Bb), the tick-borne organism which causes Lyme disease. Now, there’s evidence that Babesia, a parasite which infects red blood cells and is transmitted primarily through the bite of black-legged ticks, may have reached Canada, as well.

Now, there’s evidence that Babesia, a parasite which infects red blood cells and is transmitted primarily through the bite of black-legged ticks, may have reached Canada, as well. The organism is believed to be carried by ticks also infected with Borrelia burgdorferi.

Babesia microti can be confused with Plasmodium falciparum (Source: CDC)

Researchers have identified the first known case of Babesia microti in Manitoba, a province of Canada. Authors from the University of Manitoba reported recently in the Canadian Journal of Infectious Diseases and Medical Microbiologythat a “7-year-old boy with a complicated medical history that included asplenia, acquired an infection with Babesia microti in the summer of 2013 and had not travelled outside of Manitoba.”

The boy was successfully treated with six weeks of Atovaquone and Azithromycin.

The University of Manitoba entomologists point out that 88 cases of Babesia were reported in Canada’s neighboring states of Minnesota, Wisconsin, and North Dakota.

• Blacklegged-ticks infected with Babesia microti have been collected from six different localities in Manitoba as early as 2010.

• The prevalence of Babesia microti ticks ranged from 1.8% to as high as 10% in other locations.

• Babesia microti has also been detected in the tissues from field collected rodents at two sites.

• Infected ‘bird-borne’ ticks had been observed in Ontario.

Researchers from the Yale School of Pubic Health believe human Babesiosis is reaching new regions. They recently demonstrated that mice infected with Lyme disease and Babesia could enhance the geographic spread of the disease. According to Maria Diuk-Wasser, senior author of the Yale School of Public Health study, “The findings provide a possible answer as to why human babesiosis is only emerging in areas where Lyme disease is well established.”

Unfortunately, like many of the other tick-borne illnesses, Babesia can be difficult to diagnose. And, it cannot be effectively treated with antibiotics such as doxycycline, amoxicillin and azithromycin, which are used to treat Lyme disease, Ehrlichia and Anaplasmosis.

Typically, a co-infection of Babesia with Lyme disease can increase the severity and duration of illness. In YaleNews, Diuk-Wasser points out that multiple infections “can cause more severe symptoms and sometimes make diagnosis more difficult.”

Meanwhile, authors of a 2014 study, published in PLOS One, warn physicians to evaluate patients closely for both Lyme disease and Babesia. “Given that co-infection for these two pathogens can exacerbate symptoms and requires distinct treatment, medical practitioners should be aware of the tendency for B. microti and B. burgdorferi to co-occur when diagnosing and treating tick-borne illness.”

There are over 100 known species of Babesia, a parasite, but only a few warrant concern for humans. Most cases involve Babesia microti and Babesia duncani. The severity of Babesiosis infections can vary, but it can be life-threatening to patients with weakened immune systems and the elderly.

Some individuals can present with flu-like symptoms, which include irregular fevers, chills, sweats, lethargy, headaches, nausea, body aches and fatigue. The disease can cause a specific type of anemia, called hemolytic anemia, since the parasites infect and destroy red blood cells. There are individuals who are asymptomatic, as well.

In early cases, Babesia parasites can be seen inside red blood cells using a thick smear test, according to the CDC. But, only a third of patients with Babesiosis were diagnosed microscopically in a study in the Northeastern US by Krause and colleaguesin 1997–2000. The remaining Babesia patients were diagnosed with PCR and IgM antibody testing.

Babesia in the 7-year-old child was effectively treated with a 6-week combination of Atovaquone and Azithromycin. A combination of Atovaquone and Azithromycin was much better tolerated than Clindamycin and Quinine in a trial by Krauseet al. Metronidazole and Tinidazole are examples of treatment for Babesia that have been suggested for individuals who do not tolerate or cannot afford the combination of Atovaquone with Azithromycin. The ideal regimen has yet to be determined.

It’s important to point out that unlike Lyme disease, its been documented that Babesia can be transmitted person-to-person through blood transfusions, making the disease particularly concerning. According to a study published in the September, 2014 issue of Transfusion, “cases of transfusion-transmitted babesiosis have been increasingly recognized. To date, no Babesia test has been licensed for screening US blood donors.”

10 Replies to "Canada may see new tick-borne threat: Babesia "

Patricia Emily Schott

12/14/2019 (12:43 pm)

I live in Kentucky, USA. I presented with flu-like symptoms, 102+ fever…I continue to have a low-grade fever, extreme fatigue, aches…received a positive blood test for babesia. My dr. Sent me to an infectious disease dr who then ran a PCR, which came back negative. I continue to have episodes of flu-like symptoms with 102 fever…but neg. On flu. Are there any conditions that can mimic and give a false positive?

Connie Marcinkoski

04/04/2018 (8:51 pm)

We have a mother and her three children here in Alberta. Mother has Lyme disease. Three children tested positive for babesia, oldest daughter is quite ill now. They need treatment, can you recommend someone. They live here in Alberta, Canada.

08/31/2015 (1:13 am)

Doctors in the U.S. are increasingly recognizing Babesia following a tick bite. B. microti, the causative agent of Babesia, is the second most common infection in the tick in the NorthEastern United States. It follows a tick bite. Other modes of transmission have not been studied. It is important for a doctor to make sure the the clinical picture fits in case the Babesia test is a false positive. It is a shame that the cost has not dropped for Mepron even with the introduction of a generic product.

David

02/05/2015 (2:22 am)

Given the complete lack of Lyme/Babesia specialists in Canada, how could anyone say that this illness is “new” or “emerging”?

This narrative is nothing more than a shallow attempt of the medical community to cover their behind after decades of extreme neglect. There are over thirty know species of Babesia; only a handful of those bacteria have any identifiable lab tests. The tests that do exist are in no way reliable.

You sir are spreading misinformation in order to cover the tracks of gross medical mismanagement. You should be ashamed of yourself.

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Dr. Daniel Cameron, MD, MPH, is a nationally recognized leader for his expertise in the diagnosis and treatment of Lyme disease and other tick-borne illnesses. For more than 25 years, he has been treating adolescents and adults suffering from Lyme disease.

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Dr. Daniel Cameron, MD, MPH, is a nationally recognized leader for his expertise in the diagnosis and treatment of Lyme disease and other tick-borne illnesses. For more than 30 years, he has been treating adolescents and adults suffering from Lyme disease.